Anterior Cruciate Ligament (ACL) Tears: Hamstring Tendon Graft Preparation

Anterior Cruciate Ligament (ACL) Tears: Hamstring Tendon Graft Preparation

This video is a demonstration of a hamstring graft preparation used in ACL reconstruction. In most cases, the tendon from only one of the hamstring muscles, called the semitendinosus, is removed and will be used as the ACL graft.

The surgeon begins by securing an adjustable suture device onto a graft preparation board. The adjustable suture device contains a small metal button and multiple strands of sutures. The surgeon secures a white SutureTape loop onto the other end of the graft preparation board.

Because the hamstring graft is not thick enough as a single strand, the surgeon will need to fold the graft into four strands. The surgeon slides both ends of the graft through the white SutureTape loops, folds the graft to make the four strands, and sews the ends of the graft together with sutures to make a continuous loop.

If the surgeon will be using a suture augmentation technique during the surgery to support the graft, the flat blue suture will be positioned through the loops of the hamstring graft. Next, the surgeon will sew all four strands of the graft together with sutures and wrap the sutures around the graft to secure everything in place.

The surgeon finishes the graft preparation by sliding the graft into a sizing tube to compress and shape the graft, ready to be brought into the knee and used as the new ACL.